@layout("/common/_container.html",{js:["/assets/modular/dbServicelist/exchangeComputer.js"]}){

<form class="layui-form">
    <div class="layui-fluid">
        <div class="layui-card">
            <div class="layui-card-header" style="text-align: center">
                <span style="color: grey;font-size: 20px">数据库注册申请</span>
            </div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <div class="layui-col-md12">
                        <div class="layui-inline layui-col-md2">
                            <div style="width: 5px;height: 20px;background-color: #00a0e9;border-radius: 5px"
                                 class="layui-inline"></div>
                            <div class="layui-inline">
                                <span style="font-size: 18px">数据库注册</span>
                            </div>
                        </div>
                        <div style="text-align: right" class="layui-inline layui-col-md9">
                            <button id="returnForward" class="layui-btn  layui-btn-normal">返回</button>
                        </div>
                    </div>
                    <div class="layui-col-md12">
                        <div class="layui-col-md12" style="margin: 0 0 15px 0">
                            <div class="layui-inline layui-col-md6 layui-col-md-offset3">
                                <label class="layui-form-label">目标服务器:<span style="color: red;">*</span></label>
                                <div class="layui-input-block">
                                    <select name="exchangeId" id="exchangeId" lay-filter="exchangeId"
                                            lay-verify="required" required>
                                        <option value="">请选择</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                        <div class="layui-col-md12" style="margin: 0 0 15px 0">
                            <div class="layui-inline  layui-col-md6 layui-col-md-offset3">
                                <label class="layui-form-label">用户名:<span style="color: red;">*</span></label>
                                <div class="layui-input-block">
                                    <input id="exchangeUser" name="exchangeUser" style="color: grey"
                                           placeholder="请输入用户名" type="text"
                                           class="layui-input" lay-verify="required" required disabled/>
                                </div>
                            </div>
                        </div>
                        <div class="layui-col-md12" style="margin: 0 0 15px 0">
                            <div class="layui-inline  layui-col-md6 layui-col-md-offset3">
                                <label class="layui-form-label">密码:<span style="color: red;">*</span></label>
                                <div class="layui-input-block">
                                    <input id="exchangePassword" name="exchangePassword" style="color: grey"
                                           placeholder="请输入密码" type="text"
                                           class="layui-input" lay-verify="required" required disabled/>
                                </div>
                            </div>
                        </div>
                        <div class="layui-col-md12" style="margin: 0 0 15px 0">
                            <div class="layui-inline  layui-col-md6 layui-col-md-offset3">
                                <label class="layui-form-label">交换频率:<span style="color: red;">*</span></label>
                                <div class="layui-input-block">
                                    <select name="exchangeDate" lay-filter="exchangeDate" lay-verify="required"
                                            required>
                                        <option value="">请选择</option>
                                        <option value="1">实时</option>
                                        <option value="2">每天</option>
                                        <option value="3">每周</option>
                                        <option value="4">每月</option>
                                        <option value="5">每年</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
                <div class="form-group-bottom text-center" style="margin: 0 0 25px 0">
                    <button class="layui-btn" id="apply" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
                </div>
            </div>
        </div>
    </div>

</form>

@}